Pay for the DS... Walk out with something else.

[southernlady]

It was also the reason for the surgery wars on one forum that Diana usually started...and it was always aimed at the pre-ops...and ALWAYS ended up with those post-op defending their choice. People need to learn to READ...

It was one of those surgery war threads that made ME look at the DS. So I am thankful for the fact that she always posted them.

 

[robs477]

Which means we did our job...to educate someone on how to be pro-active and what to ask.

Regardless of which surgery a person gets, as long as they know of ALL of their options and go into the decision educated, then all is good.

Absolutely, that's what I was trying to say. If it wasn't for all that insight I received, I'm pretty for sure, I would have been deceived, there's no doubt in my mind! But, because of the time and effort you guys put in to your information sharing, at least I went in being informed as I could be. I have said thank you so many times and will say it again and again!! When I said you guys cost me five visit, that was said in jest, with sarcastic humor of course, meaning I had to go see more Dr.s because of my newly obtained knowledge regarding all the bait and switchers which I actually had happen to me THREE times!. So, please don't take it the wrong way or think that I'm not very grateful, because I am

 

[southernlady]

Absolutely, that's what I was trying to say. If it wasn't for all that insight I received, I'm pretty for sure, I would have been deceived, there's no doubt in my mind! But, because of the time and effort you guys put in to your information sharing, at least I went in being informed as I could be. I have said thank you so many times and will say it again and again!! When I said you guys cost me five visit, that was said in jest, with sarcastic humor of course, meaning I had to go see more Dr.s because of my newly obtained knowledge regarding all the bait and switchers which I actually had happen to me THREE times!. So, please don't take it the wrong way or think that I'm not very grateful, because I am

Many are not grateful cause they TRULY want to believe their doctor is ALL-KNOWING!!! Or because they want was is closest, handiest, etc.

So yes, you may have had to visit numerous surgeons but the other side of that coin is YOU pay it forward by providing the feedback on their policies. And THAT is worth it!

 

[DianaCox]

Pssst - the proper term is "Bait-and-DON'T-Switch."

 

[Sheanie]

ok that is just freakin' funny. I think as MO people we are targets, people have a preconceived picture in their head, that you are slow, fat, stupid, etc hell you did this to yourself, but that also can mean just the opposite, that enough is enough and as a DSer we are a pretty direct, get what you want type of people, I mean lets be real, most of us have had to fight for the DS, either insurance coverage, limb lengths, sleeve size, you had the gastric bypass it is the same thing, every single ailment is traced back to your DS...oh breast cancer must have been from the DS, oh thyroidectomy must have been the DS, and so on...

Well, get ready to hear EVERYTHING being blamed on the DS if you ever join some of the more stupid-tolerant forums (on Facey Space). In recent memory, I stopped counting at 5 people who blamed their tooth loss on their DS. While a link can be made from GERD to acid erosion of tooth enamel, it's not a direct DS side effect. Vomiting, eating acidic foods, drinking carbonated drinks, and other habits can also cause enamel erosion.

But stupid people will blame every little ailment they get after their DS on their WLS. Guaranteed. Just stick around and you'll read the damndest things.

 

[DianaCox]

Worse - your DOCTORS will blame everything on the DS, and not look beyond "the usual suspect" - just as they did when you were MO. And you will have to FIGHT them when they do that to get a proper workup and diagnostic tests run.

 

[Up2Me3]

Ok...so I have a follow up with my Dr. on this Wednesday. I think I am a little better prepared to discuss with him my options between DS and Loop. But here's the thing......this whole thing has been SO SO draining on me emotionally. I know - well my husband tells me - that I over analyze things to death. But seriously - because I want to be safe first and foremost I'm almost now leaning towards just the sleeve......ok...and because I'm somewhat lazy...no that's not it...just TIRED - TIRED of trying to weigh the diffences in the DS and Loop! Sigh.....! When I think just forget the whole thing...do nothing....all I want to do is go curl up and "FEED" my emotions that I'll never be rid of this weight...that weddings and other events will come and go and I'll make the same ol' excuses why I can't be there because I'm just too embarrased to say...I'm fat, out of shape, can't keep up etc etc etc etc!! Perhaps I need to be on the stressed as hell thread......is there one of those?

Could someone (Diana, Hilary, Lis, Laura, anyone) please help me work my head through this one question for him. This question arises from Hilary's post question below and the 2nd question from her post of Dr. Sanchez Pernaute's email.

#1 What is the long term impact of bile running directly across the pyloric valve?

Hilary - I may not be understanding how this could happen....as I view (dsfacts.com) the visual from normal anatomy to SADI http://www.dssurgery.com/procedures/compare-weight-loss-surgical-procedures.php ...the green colored limb carrying the bile does not seem any closer to the pyloric valve than my normal anatomy.

#2 "(The is a higher bile acid exposure to the intestinal cells and this has demonstrated an important incretin function, with improvement of the beta-cell pancreatic function.) Biliary reflux was carefully studied in the first series of patents, and results were similar to the controls in the normal population." Say whaaaat?

It seems to me, in one breath he is saying there is higher bile acid exposure and then the next he says 'results are similar to the normal population' - my concern when I hear acid exposure is .... my cousin died from esophagus cancer ....I believe they said was attributed to acid reflux....how is\does this all relate?

#3 If I have just the sleeve (and maybe I need to get on the forum threads for Sleeve only patients) what are my chances of loosing 200#'s and maintaining that loss? I would like to hope that if it aided me in GETTING there that I would find my motivation to maintain as I could then go out and live life a little easier. The main reason I over eat now (I believe) is that I can not do any of the activites that I love (horses etc).

Hoping everyone is still active on this thread....I haven't figured out how to "tag" someone specifically.

 

[revisionDS]

Worse - your DOCTORS will blame everything on the DS, and not look beyond "the usual suspect" - just as they did when you were MO. And you will have to FIGHT them when they do that to get a proper workup and diagnostic tests run.

YES!!! exactly and then they stop there....they have the answer... if I had a dollar for every time a dr said well that is because of your DS I would have many dollars. And this is after I have said NO I have blood work, xrays showing this was BEFORE, oh my gosh. ok so sometimes I think I want to deck these doctors,ENDO are by far the worse. I have 2 endocrinologists, that is 2 too many. I have fired 3 other endocrinologists and 1 hematologist. One endocrinologist is for my thyroidectomy and the other is for my metabolic bone disease, serious? come one. I am firing at least one of them. talk about stupid, I said to the Yale Metabolic bone specialist endocrinologist (which by the way doesn't know why all my bone markers are abnormal, ummm maybe because both my parents have osteoporosis, aunts, uncle, both grandparents- I am dooooomed) I want a lumper not a splitter for a dr. seriously, yep the last visit I said to my one of the endo's this is ridiculous as an endo you should be able to treat the entire endocrine system. anyway and the metabolic bone disease was caused by the DS....nope bloodwork showing BEFORE I had my DS it was like that and thank God I got the DS because prepop bloodwork, my Vit D was in the teens. I am sure other deficienes I had were because of the band, iron deficieneies and other vitamins, so as a bandster you don't test any other that stuff (I mean vit K and A) so ignorance is bliss, guess what was low for me pre op? yep you got it , A and K, one endo I fired on visit 2 said it was from the DS, I was like I had the DS for 2 months ago it cant be from the DS? Fired
So after my rambling, we have to drive our healthcare, even though every time and I mean every time I see this one endocrinologist I have to say the same thing, EVERY time she still says it is the DS. My PCP he just lets me do what I want as long as I can justify what I am doing he is ok with it (show him literature explain etc-I mean he is responsible for what he rxs, he helps every way he can and he has a lot of respect for taking control of your healthcare, and like when he is asked questions, he says that he has patients that never question anything etc, and says I make up for that, he has never once said something stupid, well I guess if he did I would have fired him also. )

 

[Brandy]

Ok...so I have a follow up with Dr. Cottam on this Wednesday. I think I am a little better prepared to discuss with him my options between DS and Loop. But here's the thing......this whole thing has been SO SO draining on me emotionally.

I can't help you with the medical details. Matter a fact, reading this whole thread has given me the willies!!

I took a fork in the 'ROAD TO WLS' before I had to understand in things in that detail. The veterans say this is a huge mistake, but I knew myself well enough to know it was my way. Truth is, it takes years and years of dedicated study to really understand medical science and that doesn't always up to agreement. Yes, you can become an expert on few things in the short run, but even that takes a great amount of time and perhaps a base of specific knowledge that I didn't have.

To me picking the surgery was easy. There is one surgery with the best long term results. One surgery that people have revisions to get, not to lose. One surgery that promises a relatively normal food life. But it wasn't really those things that sold me. It was the spirit of the people on the boards. They were loving life and could talk about things more that diet restrictions. It seemed to me that these people got better. They were no longer morbidly obese, but perhaps is a more stream lined body. They were just people. I did not want the rest of my life to revolve around my weight.

Since I knew that I was just going to have to trust my surgeon, that put the burden of the decision on finding the right surgeon and that is something any layman can do. There are a few surgeons that *everybody* says can be trusted. I just went to one of those. Perhaps it was a cop out, but I would choose it again. So although I can't help you with the deep medical questions, I can suggest that it may be easier on you (or somebody that is lurking) to rearrange your life to go to one of those trusted surgeons than to try to step into the breach of a long standing medical debate.

Your post reminded me that no matter what path you take to WLS, there will be a moment where you have to leap. When you say "I want this surgery and I want this surgeon." If you doubt your ability to understand the medical science underpinnings, then find some criteria that you can put your faith in.

Good luck!

 

[robs477]

I can't help you with the medical details. Matter a fact, reading this whole thread has given me the willies!!

I took a fork in the 'ROAD TO WLS' before I had to understand in things in that detail. The veterans say this is a huge mistake, but I knew myself well enough to know it was my way. Truth is, it takes years and years of dedicated study to really understand medical science and that doesn't always up to agreement. Yes, you can become an expert on few things in the short run, but even that takes a great amount of time and perhaps a base of specific knowledge that I didn't have.

To me picking the surgery was easy. There is one surgery with the best long term results. One surgery that people have revisions to get, not to lose. One surgery that promises a relatively normal food life. But it wasn't really those things that sold me. It was the spirit of the people on the boards. They were loving life and could talk about things more that diet restrictions. It seemed to me that these people got better. They were no longer morbidly obese, but perhaps is a more stream lined body. They were just people. I did not want the rest of my life to revolve around my weight.

Since I knew that I was just going to have to trust my surgeon, that put the burden of the decision on finding the right surgeon and that is something any layman can do. There are a few surgeons that *everybody* says can be trusted. I just went to one of those. Perhaps it was a cop out, but I would choose it again. So although I can't help you with the deep medical questions, I can suggest that it may be easier on you (or somebody that is lurking) to rearrange your life to go to one of those trusted surgeons than to try to step into the breach of a long standing medical debate.

Your post reminded me that no matter what path you take to WLS, there will be a moment where you have to leap. When you say "I want this surgery and I want this surgeon." If you doubt your ability to understand the medical science underpinnings, then find some criteria that you can put your faith in.

Good luck!

That was worded so very perfectly! Great post!

 

[Up2Me3]

I can't help you with the medical details. Matter a fact, reading this whole thread has given me the willies!!


Your post reminded me that no matter what path you take to WLS, there will be a moment where you have to leap. When you say "I want this surgery and I want this surgeon." If you doubt your ability to understand the medical science underpinnings, then find some criteria that you can put your faith in.

Good luck!

I love this last paragraph Brandy. Knowing that everyone has had to take that leap. I guess that's really what I mean by closing my eyes and jumping. How much more can I know or truly understand EVERY little thing. My doctor has done the DS. It is not his surgery of choice. He REALLY likes the SADI and what is has to offer. When I listen to him explain it I do feel a calm. I think that he is definately skilled in the SADI - even this Dr. Sanchez that Hilary was in contact with, knows of him and his work with the SADI. Just weighing now the pro's vc con's. If I decide to do traditional DS I may switch surgeons....we'll see. Being self pay I don't have to wait for all the insurance rig-a-ma-roll (? spell ha).

I think that as I have looked at the vets on here and some their surgery dates for the DS going back to late 90's early 00's - that really the DS was just as new (only 5-7 years out) - that is the same as the 5-7 years out currently for the SADI?? Perhaps it's just that their leap of faith paid off and hopefully mine with a SADI would as well. So far it does look very promising for amount of excess weight and maintenance just thus far. My main concern now that I'm trying to reconcile is the bile acid reflux potential - and if it happens - how is it treated.

Thanks for letting me vent and rant and "talk it through" .....although I drive myself a little nuts as I seem to go round and round quite a bit!

 

[DianaCox]

I think that as I have looked at the vets on here and some their surgery dates for the DS going back to late 90's early 00's - that really the DS was just as new (only 5-7 years out) - that is the same as the 5-7 years out currently for the SADI??

NO. The DS was first done in 1988. Those of us who had surgery in the late 90s - early 00s were looking at numerous data and publications, including from respected US surgeons, for 10-15 years of results.

Long term results - that's what I'm not seeing. And the required diet - I see very little discussion about the fact that there is a lot less fat malabsorption with the SADI, and a lot more carb absorption, compared to the DS.

 

[Spiky Bugger]

I love this last paragraph Brandy. Knowing that everyone has had to take that leap. I guess that's really what I mean by closing my eyes and jumping. How much more can I know or truly understand EVERY little thing. My doctor has done the DS. It is not his surgery of choice. He REALLY likes the SADI and what is has to offer. When I listen to him explain it I do feel a calm. I think that he is definately skilled in the SADI - even this Dr. Sanchez that Hilary was in contact with, knows of Dr. Cottam and his work with the SADI. Just weighing now the pro's vc con's. If I decide to do traditional DS I may switch surgeons to Dr. Simper....we'll see. Being self pay I don't have to wait for all the insurance rig-a-ma-roll (? spell ha).

I think that as I have looked at the vets on here and some their surgery dates for the DS going back to late 90's early 00's - that really the DS was just as new (only 5-7 years out) - that is the same as the 5-7 years out currently for the SADI?? Perhaps it's just that their leap of faith paid off and hopefully mine with a SADI would as well. So far it does look very promising for amount of excess weight and maintenance just thus far. My main concern now that I'm trying to reconcile is the bile acid reflux potential - and if it happens - how is it treated.

Thanks for letting me vent and rant and "talk it through" .....although I drive myself a little nuts as I seem to go round and round quite a bit!

The DS wasn't "new," in the late 1990s. Scopinaro and DeMetter had their procedures which were not good long term. In 1986, Hess "created" the Biliopancreatic Diversion with Duodenal Switch...so by the late 1990s-2000, it was more like 13-15 years old.

I don't have a problem with the SADI...EXCEPT for the way people are selling it...to patients and patients to each other. It is, to me, still an unknown quantity, and still...as far as I know...not covered by insurance.

 

[Up2Me3]

NO. The DS was first done in 1988. Those of us who had surgery in the late 90s - early 00s were looking at numerous data and publications, including from respected US surgeons, for 10-15 years of results.

Long term results - that's what I'm not seeing. And the required diet - I see very little discussion about the fact that there is a lot less fat malabsorption with the SADI, and a lot more carb absorption, compared to the DS.

So @DianaCox - when you had the DS - it was 15 years out. Where did you go to find how many DS surgeries had been performed and what the results were? The SADI-S is 5 years out in the states (7 years out of country). Dr. Sanchez (Madrid)has nearly 200 patients that he has followed for that 7 years. His results have been very good. Do you not consider this a good or rather sufficient outcome? I don't mean to be argumentative - but rather to play devils advocate a little so that I can continue to weigh pro's and con's.

At 5 years out - would we not be seeing some negatives surfacing at this point?

 

[Spiky Bugger]

I started complaining aloud about my band problems two years post-op and I was a lone voice whining in the wilderness. I was attacked on wls support groups for not following the program or not understanding what to do or needing an adjustment...everything EXCEPT the fact that the band was/is a piece of shit. That was circa 2003.

So ten years or so out, in spite of ALL of the information including that OVER HALF of the patients end up having the band removed...it's still being sold and has not yet, apparently, been bad enough to earn universal condemnation.

Just so that you understand what I'm saying--Diana can speak for herself--you DO realize that even the ASMBS does not list the SADI as a bariatric surgery. Here is their list:
https://asmbs.org/patients/bariatric-surgery-procedures

So, they apparently do not have enough data to condemn the band OR to endorse the SADI. That may just mean that they move slowly. Or it may mean that they will NEVER endorse that procedure. For me, the band was enough of a gamble. I'm not enough of a high roller to go for that much rearranging based on unproven blueprints. Maybe you are. Just go into it without trying to convince yourself it is something it clearly is not.